Midlife In The United States Research Articles

EFFECTS OF MENOPAUSE AND MARITAL TRANSITIONS ON SUBJECTIVE SEXUAL SELF-EFFICACY AMONG MIDDLE-AGED AND OLDER ADULTS

Abstract Circumstances in aging including menopause, physical decline, widowhood, divorce and remarriage may influence sexual experiences and well-being in later life. While marital transition can affect both men and women in middle and older life, menopausal transition is especially salient for aging women. This study aims to examine how subjective sexual self-efficacy changes over time and whether marital transitions and menopausal transitions moderate the trajectories. Participants completed two waves of the Midlife in the United States (MIDUS) surveys (N = 1002), ranging from 40 to 84 years of age at baseline (M = 57.44; SD = 10.17) with over half being female (54%, n = 538). Factor analysis confirmed a one-factor model with a five-item subjective sexual self-efficacy construct. Over 10 years, 12% of participants experienced marital transitions, and 29% of women reporting menstrual status experienced menopause transition. Growth curve analysis was used the examine the research questions.

REVISITING POSITIVE AFFECT: THE ROLE OF AFFECT MEAN LEVELS AND VARIABILITY ON DEPRESSION IN MID AND LATER LIFE

Abstract Recent research suggests that affect dynamics (e.g., variability) combined with mean levels are important predictors of psychological and physical health outcomes. This study explores the joint effect of affect levels and variability on depression across 10 years among middle-aged and older adults. We used the data from the second and third waves of Midlife in the United States (MIDUS) study. During telephone interviews, daily positive (PA) and negative affect (NA) were assessed across eight consecutive evenings. Daily affect mean levels were calculated by averaging daily affect across interview days, and daily affect variability was calculated as the individual’s standard deviation (iSD). Depression status was assessed using the Composite International Diagnostic Interview-Short form at baseline and 10-year follow-up. The final analytic sample includes 1,499 adults aged 55 years old on average (age range = 34-83; 55.7% female; 93% white). Logistic regression analysis was performed to test the interaction effect of daily affect mean levels and variability on depression. We found a significant interaction effect between PA mean levels and variability on depression status at follow-up. For individuals with high PA levels, higher PA variability was associated with higher odds of developing depression, after adjusting for depression and anxiety disorder at baseline. For NA, we only found main effects where higher NA variability was associated with higher odds of depression at follow-up. Findings suggest fragile high PA (i.e., variable high PA) may be a significant predictor of depression, highlighting the need for understanding PA as multidimensional construct.

ASSOCIATIONS BETWEEN DAILY STRESSORS AND ALCOHOL USE IN THE MIDUS STUDY

Abstract Daily stressors are minor but frequent challenges of everyday life (e.g., arguments). Although daily stressors are typically less severe than stressful life events, daily stressors can have more immediate effects on wellbeing. Despite this relevance, there is limited research evaluating the influence of daily stressors on alcohol use in older populations. This study examined daily associations between stressor characteristics (exposure, type, and severity) and alcohol use and evaluated differences in associations for younger/middle-aged (< 65 years) vs older adults (65+ years). Participants (n=1,603; Mage=52.82) were non-abstaining adults from the Midlife in the United States (MIDUS) study and the MIDUS Refresher who participated in 8-day diary projects. Survey items included stressor exposure (1=yes), stressor types (interpersonal, work, home, network), stressor severity (0=not at all; 1=not very; 2=somewhat; 3=very), and number of drinks. Covariates included the day of the week, sociodemographic characteristics, personality traits, psychological factors, and health behaviors. Multilevel linear regression analysis revealed that neither daily stressor exposure nor stressor severity was associated with reported alcohol use (p>0.05), but there were differences in alcohol use by stressor type. Specifically, days with interpersonal stressors were associated with reporting more drinks (p=.049), while days with work stressors were associated with reporting fewer drinks (p=.001). Further, age significantly moderated the relationship between any stressor exposure and reported alcohol use (p=.035), such that stronger relationships were observed for older adults than younger/middle-aged adults. Study findings highlight the importance of considering stressor characteristics when evaluating the covariation of daily stressors and alcohol use.

PATHWAYS TO HEALTHY AGING IN THE UNITED STATES AND JAPAN: THE ROLE OF PSYCHOSOCIAL FACTORS

Abstract The dynamics of aging vary across cultures, with Japan showing a more benign picture of aging compared to the United States. While Japanese longevity and healthier older adulthood are well known, of interest is what mechanisms lead to such results. In American society, there is a strong emphasis on being independent, while Japanese society focuses on interdependence and social harmony. This study explored possible behavioral mechanisms linking these psychosocial factors to health and examined whether the pathways differ by culture. We used the second wave (2004) of the Midlife in the United States (MIDUS) (N = 1045) and the second wave (2012) of the Midlife Development in Japan (MIDJA) studies (N = 317). Participants’ ages ranged from 30 to 83. Behavioral mechanisms were operationalized as diet, smoking, and exercise. Psychosocial factors included sense of control, positive relations with others, independence, and interdependence. We computed a health measure by combining two inflammation biomarkers (IL-6 and CRP) and two cardiovascular biomarkers (systolic blood pressure and the ratio of total-to-HDL cholesterol). We expected sense of control and independence would make significant contributions to Americans’ health while positive relations with others and interdependence would be significant for Japanese’s health. The results supported the predictions, confirming different psychosocial pathways to health for the two samples, with diet and exercise as behavioral mechanisms in both cultures. The results provide new insights into the mechanisms for healthy aging in different cultures, and offer a deeper understanding of the cultural impacts on healthy behaviors and the aging process.

COGNITIVE DISPERSION IS ASSOCIATED WITH PROTECTIVE COGNITIVE AND SOCIODEMOGRAPHIC FACTORS IN MIDUS

Abstract Research examining the relationship between an individual’s levels of variability across a range of cognitive domains (dispersion) suggests that higher dispersion may be an early indicator of future cognitive impairment. However, this literature is still in its infancy and more research is needed to systematically examine the correlates of dispersion in large-scale, national samples that include individuals across the adult lifespan. Our study thus examined the relationship between cognitive dispersion across 6 tasks, mean cognitive performance, and sociodemographic characteristics in a national sample of adults from the Midlife in the United States (MIDUS) study (n=4,198; age 55±12.45). Dispersion was calculated by generating an intraindividual standard deviation across 6 unique cognitive tasks spanning several neuropsychological domains. In contrast to past research, bivariate correlations indicated that higher levels of cognitive dispersion were associated with higher levels of mean performance across cognitive tasks (r=0.28), higher education (r=0.08), higher income (r=0.04), and younger age (r=-0.07) (all ps<.05). The positive association between cognitive dispersion and mean performance was strongest for the episodic memory and working memory tasks. These results were consistent in both wave 2 and 3 of MIDUS and replicated in regression analyses that also revealed an increase in dispersion across waves 2 and 3 of MIDUS was associated with an increase in mean performance across the two waves (b=0.05, p<.001). Results of our study point to the possibility that, in certain unimpaired adult lifespan populations, dispersion may be associated with protective cognitive and sociodemographic factors linked to healthy cognitive aging.

THE ASSOCIATION BETWEEN FINANCIAL HARDSHIP AND MARKERS OF INFLAMMATION AMONG CANCER SURVIVORS

Abstract This study examined the cross-sectional association between financial hardship and inflammation markers among cancer survivors. Furthermore, we tested if financial hardship mediated the link between education and inflammation. We used data from 304 cancer survivors (Ages = 32-90, 51% female, 81% non-Hispanic white) in the Midlife in the United States (MIDUS) wave 3 and Refresher Biomarker studies. Financial hardship was based on three domains: material (e.g., lower income to poverty line ratio), psychosocial (e.g., difficult paying bills), and behavioral (e.g., cut back on spending). We included interleukin-6 (IL-6) and c-reactive protein (CRP) as inflammation markers. Analyses were adjusted for confounders, including age, race/ethnicity, sex, marital status, body mass index (BMI), and smoking status. Analysis was conducted using the structural equation model framework. The second-order measurement model of financial hardship with three domains (material, psychosocial, and behavioral) in the first order showed a satisfactory model fit. Higher financial hardship was significantly associated with elevated CRP (Est = 0.14, SE = 0.06, p < .01) but not IL-6 (Est = -0.07, SE = 0.05, p = .13). Furthermore, financial hardship partially mediated the association between education and CRP (indirect effect: Est = -0.03, SE = 0.02, p < .05). Inflammation is a major biological pathway associated with socioeconomic disparities in long-term chronic health conditions among cancer survivors. Explicating socioeconomic conditions contributing to this disease process beyond traditional socioeconomic indicators are critical to identifying potential intervention areas to narrow the disparities.

GENERATIVITY, COGNITIVE REAPPRAISAL, AND OPTIMIZING SELF-ACCEPTANCE ACROSS MID LIFE AND OLD AGE

Abstract Midlife is an opportune time during which individuals can establish patterns of behavior (e.g., generativity) and self-regulatory processes (e.g., emotion regulation) that will optimize their psychological wellbeing and aging. We sought to test whether: 1.) generativity is directly associated with better self-acceptance, 2.) the effect of generativity is indirect and mediated by emotion regulation (i.e., cognitive reappraisal), and 3.) age moderates associations among generativity, cognitive reappraisal, and self-acceptance. Using data from the second and third waves of the Midlife in the United States (MIDUS) study (N=935, Mage=54.36, SD=11.05, Range = 34-83, 55.08% Female), results revealed that cognitive reappraisal (β= 0.07, p< .01) and older age (β= 0.06, p= .02) were associated with higher self-acceptance; however, generativity was not, and age did not predict generativity nor cognitive reappraisal. Generativity was associated with more frequent use of cognitive reappraisal (β= 0.16, p< .001), with cognitive reappraisal then significantly mediating the association between generativity and self-acceptance (Natural Indirect Effect= 0.02, SE= .01, p= .02). Age significantly interacted with generativity when predicting self-acceptance (β= 0.39, p= .02), such that the effect of generativity increased with age. These findings are important for reframing midlife as a critical developmental stage during which individuals can engage in behaviors and self-regulatory processes that optimize their self-acceptance throughout the aging process. As age did not moderate most associations, interventions could target generativity to promote effective emotion regulation and cognitive reappraisal to enhance self-acceptance across adulthood and into later life given its positive implications for wellbeing, health, and longevity.

THE CHARM OF COUNTRY LIFE? IMPACT OF RURAL CHILDHOOD RESIDENCE ON PHYSICAL AND MENTAL HEALTH IN LATER LIFE

Abstract Background: Most studies of geographic health disparities are focused on adult rural residence. However, previous studies have shown that the residential area in which one grows up during childhood has lasting impacts on adult health. In one of the only studies to date to examine the impact of rural childhood residence on mental health in middle-aged and older adults, Murchland and colleagues (2019) evaluated inequalities by childhood residence and noted elevated depressive symptoms were more common among those living in rural areas compared to those living in non-rural areas. Aims: The current study expands the model proposed by Murchland and colleagues to include further antecedents related to rural childhood residence, and to include multiple outcomes of physical and mental health among middle-aged and older adults. Method: Participants included 4614 individuals aged 40 or older recruited as part of the Midlife in the United States (MIDUS) study. Results: Consistent with Murchland’s model, childhood rurality played an important part in middle-aged and older adults’ health, despite not having a direct influence. Rurality status was impacted by parental education level and SES during childhood and was associated with the level of education obtained by the participants (and thus their occupation), which played a direct role in their current health status. Mental and physical health had differential predictors. Limitations: The study was limited by its non-diverse sample and self-reported measures. Conclusion: Further research into the impact of childhood rurality on health is needed, utilizing comprehensive self-reported and observed outcome measures.

EXPLORING THE WITHIN-PERSON RELATIONSHIP BETWEEN DAILY DISCRIMINATION AND DAILY STRESS REACTIVITY

Abstract Experiencing discrimination has been associated with a variety of negative impacts such as poorer health and well-being. Some research has shown that those who experienced discrimination at an initial timepoint were more likely to have poorer health and well-being outcomes 20 years later through the mediating role of threat appraisals and stress reactivity. Research has demonstrated a link between experiencing discrimination and affective reactions to everyday stressful experiences, however, these associations have only been studied at the between-person level. For the current study, we examined the within-person relationship in daily stress reactivity in relation to experiencing discrimination on a daily basis over the course of 20 years. Participants (n = 1,315) completed waves 1 to 3 of the Midlife in the United States (MIDUS) survey with each wave about 10 years apart in which participants were asked to self-report their daily discrimination. Participants also completed the National Study of Daily Experiences (NSDE) which was a daily diary design over 8 consecutive days asking about their daily stress reactivity. Results found that during timepoints when people experienced greater than their average level of discrimination, they also reacted more negatively to daily stressful events (b = .002, 95% CI [0.001, 0.002]). These results are particularly striking because they show that within-person changes in reported discrimination are related to changes in affective responses to daily stressors. These findings suggest that experiencing discrimination is related to greater reactivity to daily stressors, which may lead to worse physical and mental health over time.

INDIVIDUAL AND JOINT ASSOCIATIONS BETWEEN SLEEP AND PAIN ON MENTAL HEALTH: DIFFERENCES BY WORK STATUS AND OCCUPATION

Abstract Researchers have posited that healthcare workers (HCWs) are at greater risk of sleep and pain concerns due to their demanding work schedules and stressful workplace environment. Currently, more research is needed to understand the joint associations between sleep and pain and differences by work status and occupation type. This study examined the individual and joint associations between sleep and pain on mental health symptoms by workers (vs. non-workers) and HCWs (vs. non-HCWs). Data came from the Midlife in the United States (MIDUS) study (Time 1: 2004-2005; Time 2: 2013-2019). At baseline, 2,894 participants were working (2,640 were not working; n=294 HCWs). Sleep quality, sleep duration, number of pain locations, and pain interference were assessed. Over time, as sleep quality worsened, sleep duration shortened, and the number and interference of pain increased, then depressive and anxiety symptoms increased across all groups. The individual associations of poor sleep or more pain with depressive and anxiety symptoms were stronger among non-workers compared to workers. The relationships between poor sleep or more pain with depressive symptoms was stronger among HCWs compared to non-HCWs, but weaker or not statistically significant when anxiety symptoms was the outcome. There was evidence that the combination of poor sleep characteristics and greater pain exacerbated anxiety symptoms among all groups. Findings show differences in mental health as functions of sleep and pain by work status and HCW status. Evidence of the joint associations of sleep and pain support the interrelated nature of sleep and pain.

IMPACT OF CAREGIVING HOURS ON COGNITIVE OUTCOMES ACROSS ADULTHOOD

Abstract Being a caregiver has been associated with poorer physical health and well-being. The current study expands prior work by comparing cognitive functioning among individuals who were caregivers versus non-caregivers, and further examined varying caregiving hours and cognitive functioning among caregivers. Data were from waves 2 (2003-04) and 3 (2013-14) of the Midlife in the United States (MIDUS) study. A total of 2,075 individuals aged 35-86 years (Mage=55±11) were included from wave 2. We identified individuals who served as a caregiver in the past 12 months (N=264) at wave 2. Cognitive functioning was assessed by composite scores for both executive function (inductive reasoning, category verbal fluency, working memory span, processing speed, and attention switching and inhibitory control) and episodic memory (immediate and delayed free recall of 15 words). We used multiple linear regression models to examine associations between wave 2 caregiving versus non-caregiving status on wave 3 cognitive functioning (Model 1); and, among caregivers at wave 2, varying caregiving hours and wave 3 cognitive functioning (Model 2). After controlling for covariates on sociodemographic factors, and health and functional status at baseline in Model 1, caregiving was associated with better performance in episodic memory (b=.13, p<.05), but not executive function (b=-.06, p=.09). Model 2 revealed no significant association for either episodic memory or executive function. The findings supported the healthy caregiver rather than the stress process hypothesis, and that former caregiving may be associated with better memory functioning over time among middle-aged and older adults.

INFLUENCE OF COGNITION AND FUNCTIONAL LIMITATIONS ON HOSPITALIZATIONS AMONG OLDER ADULTS IN THE UNITED STATES

Abstract Background Older adults frequently seek emergency department care, with 45 visits for every 100 older adults. Many health events in later stages of life can be attributed to health conditions and behaviors during middle-age. Yet, while qualitative and quantitative analyses exist, documenting the reasons for emergency department visits among all comers, no study focuses specifically on the determinants of hospitalization among middle-aged and older adults using the emergency department. Additionally, the impact on longer-term outcomes starting in mid-life remains unknown. Objectives To determine whether impaired cognition, functional limitations, and multimorbidity in midlife predict subsequent hospitalizations in older age among older adults in the United States using core gerontology concepts such as functional limitations, multimorbidity, and cognitive impairment. Methods We performed secondary analysis of 2,221 participants from the Midlife in the United States (MIDUS) Series, a longitudinal study involving US adults aged 45 to 75 years using a balanced Generalized Estimation Equation (GEE) approach. Covariates such as as gender, education, marital status, income, race/ethnicity, social stressors, and social connectedness were adjusted for. Results Findings suggests that impaired cognition (p< 0.05), having two or more health conditions (p< 0.001) and functional limitations (p< 0.05) in midlife increases the number of hospitalizations in old age a decade later. Conclusions and Implications Health behaviors and conditions in midlife can significantly impact the number of hospitalizations among older adults and increase costs associated with hospitalizations. The promotion of preventive care, targeted interventions, and the adoption of healthier lifestyle habits in midlife may reduce hospital admissions in old age.

SLEEP TIGHT, STAY HEALTHY? MULTIDIMENSIONAL SLEEP HEALTH AND CHRONIC CONDITION DEVELOPMENT OVER ONE DECADE

Abstract Chronic conditions affect half of adults and are the leading cause of death in the United States. Healthy sleep is a modifiable risk factor, but greater information is needed about specific sleep experiences linked to chronic condition development. The present study aims to (1) identify within-person patterns of various sleep experiences (i.e., sleep health phenotypes describing sleep duration, regularity, sleep onset latency, insomnia symptoms, daytime tiredness, and nap frequency) and (2) understand the connection between transitions in sleep health phenotypes and chronic condition development. We use self-report data from a national sample of adults (N=5,026) taken from the Midlife in the United States (MIDUS) study across two waves (II and III) separated by about ten years. Latent transition analysis revealed four sleep phenotypes: good sleepers (optimal sleep across dimensions), insomnia sleepers (short duration, long sleep onset latency, high daytime tiredness, frequent insomnia symptoms), weekend catch-up sleepers (long sleep duration on weekends compared to weekdays), and nappers (frequent naps). For cardiovascular conditions, consistent insomnia sleepers (i.e., insomnia sleeper -> insomnia sleeper) were at 72% higher risk (CI:[1.04, 2.82]) than consistently good sleepers. For diabetes, consistent insomnia sleepers again were at higher risk (188%; CI:[1.72,4.79]) as were consistent nappers (128%; CI:[1.26,4.09]) and weekend catch-up sleepers -> nappers (137%; CI:[1.21,4.60]). For cancers, only nappers -> insomnia sleepers exhibited higher risk (45%; CI:[1.16,1.83]). We newly identify two sleep health phenotypes (napper and, especially, insomnia sleeper) as risks for developing life-threatening chronic conditions.

WELL-BEING IN MIDDLE-AGED ADULTS: THE MEDIATING ROLE OF SOCIAL MEDIA USE

Abstract As individuals age, social connection becomes increasingly important, and social media has the potential to facilitate social connections. This study aimed to investigate the relationship between age and well-being, focusing on the mediating role of social media use. While previous research has found social connection to be an important predictor of well-being, the specific implications of social media use for social connection on various aspects of well-being remain unclear. To explore this relationship, the study used publicly available data from the Midlife in the United States (MIDUS) study wave 3 and refresher 1, with a sample of 6871 participants (M = 56.80 yrs, SD = 14.58 yrs). Results showed that social media use played a significant mediating role in well-being, specifically in loneliness (b = 0.001, p=0.003), positive affect (b = -0.002, p< 0.001), and eudaimonic well-being (b = -0.020, p< 0.001). However, the indirect pathway from age to well-being through social media use was negative. That is, as individuals aged, they tended to use social media less frequently, which in turn was associated with worse well-being outcomes. These findings add to the expanding body of research on the complicated relationship between social media use and well-being, emphasizing the significance of focused interventions to encourage social media use for social connection in middle-aged adult populations. The study has implications for health professionals working with middle-aged adults, underlining the importance of considering social media use as a potential method of enhancing well-being.

DECLINES IN CONTROL BELIEFS OVER TIME: THE ROLE OF PERCEIVED DISCRIMINATION AND INEQUALITY

Abstract Higher control beliefs represent a key protective factor for healthy aging, broadly defined. If the benefits of control beliefs are well documented, fewer studies have focused on the antecedents of changes in control. There is empirical evidence that social stress, such as being treated unfairly or discriminated against, may erode personal control. The goal of this study was to examine perceived discrimination and inequality in relation to long-term change in control beliefs, in a national sample, using data from the Midlife in the United States (MIDUS) longitudinal study (Waves II and III, N = 2540, MIDUS II age range: 30-84, Mean=55.53, SD=11.21). Perceived discrimination was quantified as the sum of 9 items capturing experiences of daily discrimination. Perceived inequality was measured in three settings: work, family (relationship with children), and home. Both mastery and perceived constraints were used as indicators of control beliefs. The results revealed a significant decline in control between the two waves. Controlling for age, gender, education, self-rated physical health, and baseline control beliefs, higher daily discrimination and perceived inequality were significantly associated with lower control beliefs, 8 to 10 years later. There were not significant interactions with age and the patterns of results persisted when other relevant factors, such as cognitive performance and physical activity, were considered. The findings suggest that interventional programs should target (sources of) perceived discrimination and inequality and that changes in control beliefs could be considered a potential mechanism of the association between social stress and trajectories of healthy aging.

HOW DO PEOPLE PERCEIVE THEIR OWN AGE?—SELF-REFLECTION ON HEALTH STATUS

Abstract Subjective age -- how old you feel -- is a simple, but inclusive indicator of how people experience their own aging. This hypothesis-generating study sought to assess how objective and subjective indicators of well-being differ by subjective age, in order to progress our understanding of how this metric internalizes physical and psychological information. Data were drawn from the Midlife in the United States in 2004-2006 (MIDUS 2). The sample represented adults aged 50 years and over (n=612) and was divided into two groups: 1) felt younger than chronological age, and 2) felt the same or older than chronological age. Nearly four in five older adults reported feeling younger than their chronological age. Chi-square statistics showed that subjective indicators differ by subjective age. Specifically, those that felt the same/older than their chronological age were more likely to have depression or functional limitations, and report poor health status than were feeling younger group. Interestingly, bio-marker (i.e., C-reactive protein), physical and cognitive ability (i.e., gaits and episodic memory), and chronic conditions did not differ by subjective age. The findings indicate that reports of subjective age correlate with perceived rather than objective health status. Subjective age may therefore function as an indicator that health problems or life stressors are becoming internalized and overcoming an individual’s capacity to cope. Future research is needed to understand how subjective age can act as a bellweather of subjective and objective health decline.

Longitudinal associations between psychological and social well‐being: Exploring within‐person dynamics

AbstractThis study examines the longitudinal associations between psychological and social well‐being, which represent the private and public dimensions of eudaimonic well‐being, respectively. Data were drawn from the Midlife in the United States (MIDUS) project (N = 6,453). Participants were assessed at three‐time points, each approximately a decade apart. Both between‐person and within‐person associations between social and psychological well‐being are examined. The results reveal a strong between‐person association, consistent with previous cross‐sectional results. In addition, novel insights are gained by uncovering longitudinal within‐person associations that suggest consistent and coordinated changes in psychological and social well‐being over time. More specifically, deviations from typical levels in one dimension are associated with corresponding deviations in the other dimension after about 10 years, suggesting a reciprocal link. Notably, person‐specific changes in social well‐being are a better predictor of subsequent changes in psychological well‐being, than the other way around. These findings underscore the interdependence of the two facets of eudaimonic well‐being and highlight the importance of considering both dimensions in intervention strategies. Taken together, these findings enrich our understanding of the dynamic nature of eudaimonic well‐being. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.

Family strain, but not family support, is linked to worse pain interference among midlife adults reporting new chronic pain.

Although family relationship quality has been linked to later chronic pain incidence for aging adults, it is unclear whether the quality of these relationships is linked to the impact of pain. We estimated longitudinal associations between family relationship quality (i.e., family support and family strain) and pain interference for adults who develop novel chronic pain across 10 years of midlife. We conducted a secondary analysis of data from the Midlife in the United States (MIDUS) study. Using path analysis, we tested whether family support and strain reported by participants (54% female, age M = 54.8 years) who denied having chronic pain at the study's second wave (MIDUS 2, 2004-2006) but reported chronic pain 10 years later (MIDUS 3, 2014-2016; N = 406) was associated with the interference of that pain with daily activities after accounting for key covariates, including sociodemographics, depression symptoms, global physical health, and MIDUS 3 reports of family support and strain. The hypothesized model demonstrated good fit to the data based on multiple model fit indices. Greater family strain at baseline, but not family support, was significantly associated with greater pain interference 10 years later. Findings build on prior studies to suggest that not only are stressful family relationships likely associated with the odds of developing chronic pain, but they are also linked to the interference of that chronic pain when it develops. We recommend biopsychosocial screening in primary care that captures family relationship quality and can inform best practices for nonpharmacological, family-based pain management. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Associations between insulin‐like growth factor‐1 and executive function in normoglycemia, prediabetes, and type 2 diabetes mellitus

AbstractBackgroundThe relationship between insulin‐like growth factor‐1 (IGF‐1) and cognition has been studied in healthy individuals, yet the results have been inconclusive. The aim of this study was to determine whether the association between IGF‐1 and executive function differs in individuals with normoglycemia, prediabetes, and type 2 diabetes mellitus (T2DM).MethodThe Midlife in the United States (MIDUS) study used the Brief Test of Adult Cognition by Telephone (BTACT) to assess cognitive function. A composite z‐score for executive function was created from the following tests: Digits backward span, category fluency, number series, backward counting, and Stop and Go Switch Task (SGST). IGF‐1 levels were measured from fasting blood samples using an immunochemiluminescent assay. Normoglycemia was defined as individuals without a physician diagnosis of diabetes and glycated hemoglobin (HbA1c) < 5.6%. Prediabetes was defined as those without a physician diagnosis of diabetes and HbA1c between 5.7%‐6.4%. T2DM was defined as anyone with a physician diagnosis of diabetes, or HbA1c ≥6.5%, or use of oral hypoglycemic medication. Multiple imputation was used to handle missing covariate data. A linear regression model controlling for demographic factors, homeostatic model of insulin resistance (HOMA‐IR), C‐reactive protein (CRP) levels, exercise, smoking, sleep disturbance, alcohol intake and medication use, was used to determine the cross‐sectional association between IGF‐1 and executive function across subgroups.ResultThe MIDUS dataset included 447 normoglycemia (47.0% female, mean age 53.4±9.6), 467 prediabetes (57.4% female, mean age 56.8±10.6), and 271 T2DM participants (53.1% female, mean age 57.5±9.8). In participants with prediabetes, IGF‐1 levels were associated with better executive function (β = 0.126, p = 0.007), particularly in males (β = 0.258, p<0.001). This association was absent in individuals with normoglycemia or T2DM. Compared to males with prediabetes, the opposite trend was observed in males with T2DM (β = ‐0.181, p = 0.062).ConclusionThe findings of this study suggest that the association between IGF‐1 and executive function may be influenced by insulin resistance or T2DM. Gaining a better understanding of why the associations differ in T2DM compared to prediabetes may explain the inconsistency observed in the literature and help elucidate the mechanism behind cognitive decline in T2DM.

Exposure to childhood maltreatment predicts adult physiological dysregulation, particularly inflammation.

Although a growing literature describes the effects of negative childhood experiences on biological outcomes, it is difficult to compare results across studies because of differences in measures of childhood experiences, biological markers, sample characteristics, and included covariates. To ensure comparability across its analyses, this study used a single national survey of adults in the United States-the Midlife in the United States (MIDUS) study-to examine comprehensively the association between adverse childhood experiences, operationalized as childhood maltreatment (CM), and biological markers of risk for poor health and to assess whether these associations differ by type of maltreatment, sex, or race. The sample included 1254, mostly White (78%), adults aged 34-86 years (mean age 57 years), 57% of whom were female. We present incidence rate ratios (IRR) from negative binomial and Poisson regressions to examine the relationships between exposure to CM (emotional, physical, and sexual abuse; emotional and physical neglect; and a CM-index reflecting frequency across all five types of maltreatment) and four biological risk summary scores (overall physiological dysregulation, cardiometabolic risk, inflammation, and hypothalamic pituitary axis/sympathetic nervous system (HPA/SNS) function). We also tested whether the effect of each type of CM varied by sex and by race. The CM-index was associated with higher overall physiological dysregulation and inflammation, but the associations were weaker and not statistically significant for cardiometabolic risk and HPA/SNS function. With the exception of a possible sex difference in the association between sexual abuse and overall physiological dysregulation, there was little evidence that the associations varied systematically by type of CM or by sex or race. We conclude that exposure to CM predicts adult biological risk, particularly inflammation. Inconsistency with previous research suggests that additional research is needed to confirm findings regarding sex and race differences.